Dozens of House Democrats warn Trump administration against Medicaid block grants

Greg Nash

More than 30 House Democrats are warning the Trump administration that it should not allow states to turn their Medicaid funding into block grants.

The letter, led by Rep. Joe Kennedy III (D-Mass.) and signed by 35 other Democrats, argues that block grants are illegal.

“The administration should not issue any guidance encouraging block grant waivers, should reject these waivers and the concept of block grants, and urge any state that is considering this misguided policy to commit its energy to implementing Medicaid as Congress intends,” the Democrats wrote. 

Trump administration health officials on Thursday are poised to release a plan that will encourage states to apply for permission to cap their Medicaid funding. Imposing block grants in Medicaid has long been a major conservative goal, and would represent a radical departure from how the Medicaid program operates. 

A block grant would transform Medicaid from an open-ended entitlement program into one with capped benefits. Currently, the federal government matches a certain percentage of state spending, and the funding changes depending on how many people need coverage.

Under a block grant, states would receive a fixed amount of money from the federal government, regardless of outside circumstances, that they could spend however they see fit without any federal guidelines.

“Previous statements from the administration make it clear that the goal of these block grants is to cut benefits and further limit access to publicly funded health care,” the lawmakers wrote.

Block grants are popular with Republicans who want to constrain Medicaid spending but are fiercely opposed by Democrats, who argue the changes require harmful cuts in the program.

Congress previously rejected block grants when the GOP’s ObamaCare repeal bill failed in 2017. But the new policy would be optional for states, some of which may jump at the opportunity.

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